Symlin & MDI?

Anyone using Symlin who also does MDI versus pump? I’d like to hear your experience with the two. I’m struggling a bit. I’m on the first few days - up to 45 mcg right now. No nausea - I do get this really weird “knot” in my stomach sometimes.

I’ve been on low carb and Lantus/Novolog for awhile - last week my latest A1c was 5.4, which is terrific. The only reason I wanted to try Symlin is because over the past year, since starting insulin, I’ve gained 20 lbs and nothing I do seems to budge it. It’s frustrating - it’s “not me” - and I want to get back to my fighting weight.

By the way, the guidelines say at least 30 carbs OR 250 calories, so I’ve followed that - along with a lot of Jason’s helpful guidelines - and haven’t had any horrible lows.

Anyway, my doc told me to lower my basal but I think that’s wrong - I think Jason said I may need to raise my basal? I’m having horrible DP at the same night time basal rate I was on before Symlin - I tried the Symlin/correction thing in the wee morning hours but that gave me an awful gnawing stomach ache. BUT, if I have to raise my basal even though I’m lowering my boluses, is this going to help my overall insulin resistance and the weight that came with it?

Should I hold off on Symlin unless I get a pump? I’ve been resisting the pump because I work at home so MDI is no biggie, and I am very fair with very thin skin and am afraid of scar tissue. However, if that’s the best solution for lowering my insulin/resistance, maybe I should go that route. Right now I take Lantus 2x day (30 U total) and Novolog (4-6 per meal + corrections, which has been slowly increasing as resistance increases).

Any help or guidance is appreciated.


I’ve been on Symlin for about 6 mos. I started it before I went on the pump. I was on Levemir (13 units) and Novolog (between 2-4 units per meal). With Levemir, I put on about 14 lbs. Too much weight for the little person I am.
When I started the Symlin, everything was cut down. The Levemir, the long acting insulin was cut , The Novolog was cut to 1/2 of what I had been taking. My lows were too dangerous.
When I went on the pump and stopped taking the Levemir, weight started dropping as well. With the symlin and lack of Levemir, I am within 3 pounds of my original weight.
Perhaps you should have a chat with your Dr…

PS…I am now taking 60 units of Symlin prior to each meal. I do not eat 30 carbs per meal and have had no nausea or any other problems.
I started the Symlin with 15 units and every 3 days increased the dosage on the advice of my endo, to where I am now
Good luck!

Thanks, Dee. All good, encouraging information! My first day on 60 mcg and things are improving as I’m getting the hang of it, basically bolusing about 1 hour after eating, at a much lower amount. I was up to 4-6 units before meals, that’s now half.

I’ve reduced my day time basal (I use Lantus 2x day - Levemir didn’t work for my purposes as I required twice as much as Lantus for the same result) - but not my night time (14 U) - at least not yet. When I tried, that’s when I got the terrible DP - so we’ll see as it progresses.

Next - the pump!!

I’m now pumpless (and not in a hurry to go back) and was thinking about trying Symlin again, sans pump. Any advice for MDI’ers out there? Do I really need to back off my levemir? Last time I spiked 3-4 hours after eating and it stopped working altogether after 6 months so I went off. Was thinking about trying it again…